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2型糖尿病对心力衰竭的预后影响,其中有轻微减少的射出分数
Tobias Schupp1, Mohammad Abumayyaleh1, Kathrin Weidner1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.
Journal of clinical medicine
|February 10, 2024
概括
2型糖尿病在心力衰竭中普遍存在,其喷射率略有降低 (HFmrEF),并显著增加死亡风险. 胰岛素治疗进一步提高了HFmrEF患者的风险.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 临床研究 临床研究
背景情况:
- 有限的数据存在于2型糖尿病 (T2D) 中的心力衰竭与轻微减少的射出分数 (HFmrEF).
- 调查HFmrEF中T2D的患病率和预后影响对于患者管理至关重要.
研究的目的:
- 为了确定HFmrEF患者T2D的流行率.
- 评估T2D对长期结果的影响,包括所有原因的死亡率和与HF相关的再住院.
主要方法:
- 从2016-2022年对2169名HFmrEF患者 (LVEF41-49%) 的回顾性分析.
- 糖尿病患者和非糖尿病患者之间的结局的比较.
- 统计分析包括卡普兰-梅尔,多变量考克斯回归和倾向得分匹配.
主要成果:
- 在HFmrEF队列中,T2D患病率为36%.
- 糖尿病患者的30个月全因死亡率显著增加 (HR 1.273) 和与HF相关的再住院 (HR 1.714).
- 糖尿病患者的胰岛素治疗与较高的死亡率有关,与其他抗糖尿病药物不同.
结论:
- 在HFmrEF中,T2D是一种常见的并发症.
- 在HFmrEF患者中,T2D是不利的长期预后的独立预测因素.
- 特定的抗糖尿病治疗,如胰岛素,可能需要在HFmrEF管理中仔细考虑.
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